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Folic Acid Antagonists: Antimicrobial and Immunomodulating Mechanisms and Applications
International Journal of Molecular Sciences Review Folic Acid Antagonists: Antimicrobial and Immunomodulating Mechanisms and Applications Daniel Fernández-Villa 1, Maria Rosa Aguilar 1,2 and Luis Rojo 1,2,* 1 Instituto de Ciencia y Tecnología de Polímeros, Consejo Superior de Investigaciones Científicas, CSIC, 28006 Madrid, Spain; [email protected] (D.F.-V.); [email protected] (M.R.A.) 2 Consorcio Centro de Investigación Biomédica en Red de Bioingeniería, Biomateriales y Nanomedicina, 28029 Madrid, Spain * Correspondence: [email protected]; Tel.: +34-915-622-900 Received: 18 September 2019; Accepted: 7 October 2019; Published: 9 October 2019 Abstract: Bacterial, protozoan and other microbial infections share an accelerated metabolic rate. In order to ensure a proper functioning of cell replication and proteins and nucleic acids synthesis processes, folate metabolism rate is also increased in these cases. For this reason, folic acid antagonists have been used since their discovery to treat different kinds of microbial infections, taking advantage of this metabolic difference when compared with human cells. However, resistances to these compounds have emerged since then and only combined therapies are currently used in clinic. In addition, some of these compounds have been found to have an immunomodulatory behavior that allows clinicians using them as anti-inflammatory or immunosuppressive drugs. Therefore, the aim of this review is to provide an updated state-of-the-art on the use of antifolates as antibacterial and immunomodulating agents in the clinical setting, as well as to present their action mechanisms and currently investigated biomedical applications. Keywords: folic acid antagonists; antifolates; antibiotics; antibacterials; immunomodulation; sulfonamides; antimalarial 1. -
FLAMAZINE™ CREAM 1.0% W/W
PRODUCT INFORMATION NAME OF THE MEDICINE: FLAMAZINE™ CREAM 1.0% w/w Silver sulfadiazine 1% w/w Composition: Active ingredient. Silver sulfadiazine. Excipients. Polysorbate 60 Ph. Eur, Polysorbate 80 Ph. Eur, Glyceryl Monostearate Ph. Eur, Cetyl Alcohol Ph. Eur, Liquid Paraffin Ph. Eur, Propylene Glycol Ph. Eur and Purified Water Ph. Eur. DESCRIPTION: A sterile white hydrophilic cream containing silver sulfadiazine 1%. The cream is a semisolid oil-in-water emulsion. The silver sulfadiazine is in a fine micronised form. Silver sulfadiazine is a white or creamy-white, odourless or almost odourless crystalline powder, which becomes yellow on exposure to light. Practically insoluble in water; slightly soluble in acetone; practically insoluble in alcohol, chloroform or ether; freely soluble in strong ammonia solution. Chemical name: Silver salt of N’-(pyrimidin-2-yl)sulfanilamide. C10H9AgN4O2S. M.W. 357.1 CAS 22199-08-2 Chemical structure: PHARMACOLOGY: Silver sulfadiazine is a sulfonamide and has broad antimicrobial activity against both Gram- positive and Gram-negative organisms. Silver sulfadiazine acts on the cell membrane and cell wall. Unlike sulfadiazine or other sulfonamides, the antibacterial action of the silver salt of sulfadiazine does not appear to depend on inhibition of folic acid synthesis. Its action is not antagonised by p-aminobenzoic acid. Flamazine Cream: 1 June 2010 1 of 6 Microbiology: Silver sulfadiazine has broad antimicrobial activity against both Gram-positive and Gram-negative organisms including Pseudomonas aeruginosa, some yeasts and fungi. It has also been reported to be active in vitro against herpes virus and Treponema pallidum. Sulfonamides act by interfering with the synthesis of nucleic acids in sensitive micro- organisms by blocking the conversion of p- aminobenzoic acid to the co-enzyme dihydrofolic acid. -
Infektionskongress 11. Österreichischer
11. ÖSTERREICHISCHER INFEKTIONSKONGRESS WAS SIE IMMER SCHON WISSEN WOLLTEN Diagnostik – Therapie – Prophylaxe 29. März bis 1. April 2017 Hotel Gut Brandlhof, Saalfelden Information & Anmeldung: www.oegit.eu PROGRAMM PROGRAMM PROGRAMM VORWORT Unser ganz besonderer Dank gilt natürlich auch heuer wieder unseren Spon soren, die uns trotz schwieriger Zeiten im Gesundheitswesen die Treue halten. Ohne deren nachhaltiges Engagement wäre dieser Kongress in der gewohnten Form nicht realisierbar. Heuer haben wir auch eine kleine technische Neuigkeit für Sie vorbereitet: Sie werden während der Vorträge im Plenarsaal über Ihr Mobiltelefon anonym Fragen an die Referenten stellen können. Näheres werden Sie vor Ort am Brandlhof erfahren. Unten finden Sie den dafür nötigen QRCode bzw. Link. Sehr geehrte Kollegin, sehr geehrter Kollege, Wir hoffen, Ihnen mit dem vorliegenden Programm spannende Tage im Brandl wir freuen uns, Sie im Namen des Vorstandes der Österreichischen Gesellschaft für hof bieten zu können, und freuen uns schon auf das persönliche Gespräch mit Infektionskrankheiten und Tropenmedizin am 11. Österreichischen Infektions Ihnen in den Pausen. kongress in Saalfelden begrüßen zu dürfen. Das heurige Kongressthema „Was Sie immer schon wissen wollten: Diagnostik – Therapie – Prophylaxe“ steht für die Diskussion offener infektiologischer Frage stellungen und lädt zu interessanten Vorträgen ein. Das infektiologische Potpourri ist breit und behandelt den sinnvollen Einsatz von Kombinations Mit kollegialen Grüßen Xcom.events/oeginfekt therapien, ungewöhnliche Erkrankungen bei Asylsuchenden & Migranten sowie Impfungen – um nur ein paar Highlights des Kongresses zu nennen. Es ist uns auch heuer wieder gelungen, namhafte ReferentInnen zu wichtigen Themen zu gewinnen. Herr Professor Lemmen aus Aachen wird den Eröffnungs Univ.Prof. Dr. Cornelia LassFlörl Univ.Prof. -
Management of Otitis
Chronic and recurrent otitis is Management of Otitis frustrating! • Otitis externa is the most common ear disease in the cat and dog • Reported incidence is 10-20% in the dog Lindsay McKay, DVM, DACVD and 2-10% in the cat [email protected] • It is a common reason for referral to VCA Arboretum View Animal Hospital dermatology specialists and very common clinical problem for general practitioners 1- Primary causes- directly Breaking down the problem induce otic inflammation • ALLERGIES (atopy and food allergies) • Step 1- Identify the primary cause of otitis • Parasites (Otodectes cyanotis, Demodicosis) • Step 2- Assess for predisposing factors of • Masses (tumors and polyps) otitis • Foreign bodies (ex plant awns, hair, • Step 3- Treat the secondary infections ceruminoliths, hardened medications) • Step 4- Identify the perpetuating factors of • Disorders of keratinization (hypothyroidism, otitis primary seborrhea, sebaceous adenitis) • Immune mediated disease (pemphigus, juvenile cellulitis, vasculitis) What are most common causes of 2- Predisposing factors of ear disease recurrent otitis…. • These factors facilitate inflammation by changing • Allergic disease in the dog- over 40% cases environment of the ear! in one study • Ear conformation- stenotic • Polyps and ear mites in the cat canals, hair in canals, pendulous ears • Excessive moisture or cerumen production • Treatment effects- irritation from meds/contact allergy or trauma from cleaning 1 3- Secondary bacterial and/or 4- Perpetuating factors- prevent yeast infections the resolution -
Sulfonamides and Sulfonamide Combinations*
Sulfonamides and Sulfonamide Combinations* Overview Due to low cost and relative efficacy against many common bacterial infections, sulfonamides and sulfonamide combinations with diaminopyrimidines are some of the most common antibacterial agents utilized in veterinary medicine. The sulfonamides are derived from sulfanilamide. These chemicals are structural analogues of ρ-aminobenzoic acid (PABA). All sulfonamides are characterized by the same chemical nucleus. Functional groups are added to the amino group or substitutions made on the amino group to facilitate varying chemical, physical and pharmacologic properties and antibacterial spectra. Most sulfonamides are too alkaline for routine parenteral use. Therefore the drug is most commonly administered orally except in life threatening systemic infections. However, sulfonamide preparations can be administered orally, intramuscularly, intravenously, intraperitoneally, intrauterally and topically. Sulfonamides are effective against Gram-positive and Gram-negative bacteria. Some protozoa, such as coccidians, Toxoplasma species and plasmodia, are generally sensitive. Chlamydia, Nocardia and Actinomyces species are also sensitive. Veterinary diseases commonly treated by sulfonamides are actinobacillosis, coccidioidosis, mastitis, metritis, colibacillosis, pododermatitis, polyarthritis, respiratory infections and toxo- plasmosis. Strains of rickettsiae, Pseudomonas, Klebsiella, Proteus, Clostridium and Leptospira species are often highly resistant. Sulfonamides are bacteriostatic antimicrobials -
2021 Formulary List of Covered Prescription Drugs
2021 Formulary List of covered prescription drugs This drug list applies to all Individual HMO products and the following Small Group HMO products: Sharp Platinum 90 Performance HMO, Sharp Platinum 90 Performance HMO AI-AN, Sharp Platinum 90 Premier HMO, Sharp Platinum 90 Premier HMO AI-AN, Sharp Gold 80 Performance HMO, Sharp Gold 80 Performance HMO AI-AN, Sharp Gold 80 Premier HMO, Sharp Gold 80 Premier HMO AI-AN, Sharp Silver 70 Performance HMO, Sharp Silver 70 Performance HMO AI-AN, Sharp Silver 70 Premier HMO, Sharp Silver 70 Premier HMO AI-AN, Sharp Silver 73 Performance HMO, Sharp Silver 73 Premier HMO, Sharp Silver 87 Performance HMO, Sharp Silver 87 Premier HMO, Sharp Silver 94 Performance HMO, Sharp Silver 94 Premier HMO, Sharp Bronze 60 Performance HMO, Sharp Bronze 60 Performance HMO AI-AN, Sharp Bronze 60 Premier HDHP HMO, Sharp Bronze 60 Premier HDHP HMO AI-AN, Sharp Minimum Coverage Performance HMO, Sharp $0 Cost Share Performance HMO AI-AN, Sharp $0 Cost Share Premier HMO AI-AN, Sharp Silver 70 Off Exchange Performance HMO, Sharp Silver 70 Off Exchange Premier HMO, Sharp Performance Platinum 90 HMO 0/15 + Child Dental, Sharp Premier Platinum 90 HMO 0/20 + Child Dental, Sharp Performance Gold 80 HMO 350 /25 + Child Dental, Sharp Premier Gold 80 HMO 250/35 + Child Dental, Sharp Performance Silver 70 HMO 2250/50 + Child Dental, Sharp Premier Silver 70 HMO 2250/55 + Child Dental, Sharp Premier Silver 70 HDHP HMO 2500/20% + Child Dental, Sharp Performance Bronze 60 HMO 6300/65 + Child Dental, Sharp Premier Bronze 60 HDHP HMO -
A Guide to Choosing the Right Therapy
Otitis Externa A GUIDE TO CHOOSING THE RIGHT THERAPY Darin Dell, DVM, DACVD are very uncommon. If there is an underlying allergy, Animal Dermatology Clinic, Indianapolis it is mild or just beginning. This presentation will and Fort Wayne, IN respond to almost any otic product you choose. Common choices include gentamicin, florfenicol, As we discussed in a previous article, otitis externa is or polymyxin as the antibiotic and clotrimazole, a frequent presenting complaint requiring a systematic miconazole, or terbinafine as the antifungal drug. 1 approach to resolve. This article will discuss the Some cases will respond to daily ear cleaning. basics of how to choose therapy for otitis externa. Other cases will respond to less common One important note before we proceed; no two cases therapeutics such as microsilver and lactoferrin/ of otitis externa are exactly alike, so practitioners need lactoperoxidase. to use the information collected during examination to fine-tune their recommendations. I will present seven #2 common otitis externa scenarios to make the OTITIS WITH SEVERE discussion easier. Specific ingredients will be INFLAMMATION discussed individually but almost all of the commercially (ERYTHEMA, EDEMA, OR BOTH) available otic preparations are combinations of Patients in this category typically have a history of antibiotic, antifungal, and steroid medications. otitis. Cytology is still likely to show cocci and yeast although with chronicity the likelihood of rod-shaped #1 bacteria increases. There is almost always an UNCOMPLICATED OTITIS EXTERNA underlying allergy and if otitis externa occurs Patients in this category generally do not have a long frequently the allergy needs to be better controlled. -
Dermatologic Therapeutics: Bread and Butter and Beyond
Dermatologic Therapeutics: Bread and Butter and Beyond Bonnie Mackool, MD, MSPH Assistant Professor of Dermatology, Harvard Medical School Massachusetts General Hospital Disclosures Neither I nor my spouse/partner has a relevant financial relationship with a commercial interest to disclose. Medication Overview: Anti-microbial Anti-inflammatory Anti-histaminic Anti-neoplastic Retinoids Biologics Immunosuppressive Hormonal Therapy Systemic Agents Topical Agents Balneotherapy Cryotherapy Phototherapy Laser Radiation Surgical Dermatologic Medical Armamentarium Includes: • Adapalene (Differin) cream/gel • Cyclosporine (Neoral) • Azelaic acid (Azelex) cream • Adalimumab (Humira) • Topical steroids • Etanercept (Enbrel) • Tetracycline • Intravenous Immunoglobulin IVIG • Minocycline • Doxycycline • Anthralin (Drithrocream) • Dapsone (Aczone) gel • Mupirocin (Bactroban)ointment • Benzoyl peroxide + clinda or erythro • Tacrolimus ointment • Finasteride (Propecia) • Pimecrolimus cream • Tazarotene • Metronidazole (Metrocream/gel) • Tretinoin cream • Hydroxyzine (Atarax) • Methotrexate • Tri-Luma cream (tret, hydroquinone, ster) • Sodium thiosulfate IV • Hydroxychloroquine • Mycophenolate mofetil (cellcept) • Chloroquine • Azathioprine (Imuran) Dermatologic Medical Armamentarium (cont.): • Spironolactone • Calcipotriene (Dovonex) oint/cr • Isotretinoin (Accutane) • Acyclovir (Zovirax) tabs/oint/cr • 5 Fluorouracil (Efudex) cream/solution • Naltrexone • Imiquimod (Aldara) cream • Gabapentin (Neurontin) • Rituximab (Rituxan) • Doxepin Hydrochloride -
Silver Sulfadiazine)
SILVADENE® CREAM 1% (silver sulfadiazine) DESCRIPTION SILVADENE Cream 1% is a soft, white, water-miscible cream containing the antimicrobial agent silver sulfadiazine in micronized form, which has the following structural formula: Each gram of SILVADENE Cream 1% contains 10 mg of micronized silver sulfadiazine. The cream vehicle consists of white petrolatum, stearyl alcohol, isopropyl myristate, sorbitan monooleate, polyoxyl 40 stearate, propylene glycol, and water, with methylparaben 0.3% as a preservative. SILVADENE Cream 1% (silver sulfadiazine) spreads easily and can be washed off readily with water. CLINICAL PHARMACOLOGY Silver sulfadiazine has broad antimicrobial activity. It is bactericidal for many gram-negative and gram-positive bacteria as well as being effective against yeast. Results from in vitro testing are listed below. Sufficient data have been obtained to demonstrate that silver sulfadiazine will inhibit bacteria that are resistant to other antimicrobial agents and that the compound is superior to sulfadiazine. Studies utilizing radioactive micronized silver sulfadiazine, electron microscopy, and biochemical techniques have revealed that the mechanism of action of silver sulfadiazine on bacteria differs from silver nitrate and sodium sulfadiazine. Silver sulfadiazine acts only on the cell membrane and cell wall to produce its bactericidal effect. Results of In Vitro Testing with SILVADENE® Cream 1% (silver sulfadiazine) Concentration of Silver Sulfadiazine Number of Sensitive Strains/Total Number of Strains Tested Genus -
Preferred Drug List
Kansas State Employee ANALGESICS Second Generation cefprozil Health Plan NSAIDs cefuroxime axetil diclofenac sodium delayed-rel Preferred Drug List diflunisal Third Generation etodolac cefdinir 2021 ibuprofen cefixime (SUPRAX) meloxicam nabumetone Erythromycins/Macrolides naproxen sodium tabs azithromycin naproxen tabs clarithromycin oxaprozin clarithromycin ext-rel sulindac erythromycin delayed-rel erythromycin ethylsuccinate NSAIDs, COMBINATIONS erythromycin stearate diclofenac sodium delayed-rel/misoprostol fidaxomicin (DIFICID) Effective 04/01/2021 NSAIDs, TOPICAL Fluoroquinolones diclofenac sodium gel 1% ciprofloxacin For questions or additional information, diclofenac sodium soln levofloxacin access the State of Kansas website at moxifloxacin http://www.kdheks.gov/hcf/sehp or call COX-2 INHIBITORS Penicillins the Kansas State Employees Prescription celecoxib amoxicillin Drug Program at 1-800-294-6324. amoxicillin/clavulanate The Preferred Drug List is subject to change. GOUT amoxicillin/clavulanate ext-rel To locate covered prescriptions online, allopurinol ampicillin access the State of Kansas website at colchicine tabs dicloxacillin http://www.kdheks.gov/hcf/sehp for the probenecid penicillin VK most current drug list. colchicine (MITIGARE) Tetracyclines What is a Preferred Drug List? OPIOID ANALGESICS doxycycline hyclate A Preferred Drug List is a list of safe and buprenorphine transdermal minocycline cost-effective drugs, chosen by a committee codeine/acetaminophen tetracycline of physicians and pharmacists. Drug lists fentanyl -
World Health Organization Model List of Essential Medicines, 21St List, 2019
World Health Organizatio n Model List of Essential Medicines 21st List 2019 World Health Organizatio n Model List of Essential Medicines 21st List 2019 WHO/MVP/EMP/IAU/2019.06 © World Health Organization 2019 Some rights reserved. This work is available under the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 IGO licence (CC BY-NC-SA 3.0 IGO; https://creativecommons.org/licenses/by-nc-sa/3.0/igo). Under the terms of this licence, you may copy, redistribute and adapt the work for non-commercial purposes, provided the work is appropriately cited, as indicated below. In any use of this work, there should be no suggestion that WHO endorses any specific organization, products or services. The use of the WHO logo is not permitted. If you adapt the work, then you must license your work under the same or equivalent Creative Commons licence. If you create a translation of this work, you should add the following disclaimer along with the suggested citation: “This translation was not created by the World Health Organization (WHO). WHO is not responsible for the content or accuracy of this translation. The original English edition shall be the binding and authentic edition”. Any mediation relating to disputes arising under the licence shall be conducted in accordance with the mediation rules of the World Intellectual Property Organization. Suggested citation. World Health Organization Model List of Essential Medicines, 21st List, 2019. Geneva: World Health Organization; 2019. Licence: CC BY-NC-SA 3.0 IGO. Cataloguing-in-Publication (CIP) data. CIP data are available at http://apps.who.int/iris. -
(COVID-19) Pandemic on Antimicrobial Prevalence and Prescribing in a Tertiary Hospital in Singapore
Effects of Coronavirus Disease 2019 (COVID-19) Pandemic on Antimicrobial Prevalence and Prescribing in a Tertiary Hospital in Singapore Tat Ming Ng ( [email protected] ) Tan Tock Seng Hospital https://orcid.org/0000-0002-4570-3266 Sock Hoon Tan Tan Tock Seng Hosptal Shi Thong Heng Tan Tock Seng Hospital Hui Lin Tay Tan Tock Seng Hospital Min Yi Yap Tan Tock Seng Hospital Boon Hou Chua Tan Tock Seng Hospital Christine B Teng National University of Singapore David C Lye National Centre for Infectious Diseases, Tan Tock Seng Hospital, Singapore Tau Hong Lee National Centre for Infectious Diseases, Tan Tock Seng Hospital Research Keywords: COVID-19, antimicrobial prevalence, Singapore, resources, antimicrobial stewardship, pandemic Posted Date: November 2nd, 2020 DOI: https://doi.org/10.21203/rs.3.rs-97787/v1 License: This work is licensed under a Creative Commons Attribution 4.0 International License. Read Full License Page 1/14 Version of Record: A version of this preprint was published on February 3rd, 2021. See the published version at https://doi.org/10.1186/s13756-021-00898-8. Page 2/14 Abstract Background: The deployment of antimicrobial stewardship (AMS) teams to deal with the COVID-19 pandemic can lead to a loss of developed frameworks, best practices and leadership resulting in adverse impact on antimicrobial prescribing and resistance. We aim to investigate effects of reduction in AMS resources during the COVID-19 pandemic on antimicrobial prescribing and resistance. Methods: One of 5 full-time equivalent AMS pharmacists was deployed to support pandemic work and AMS rounds with infectious disease physicians were reduced from 5 to 2 times a week.